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Michelle Jackman - One of the best experts on this subject based on the ideXlab platform.
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effectiveness of Cognitive Orientation to daily occupational performance over and above functional hand splints for children with cerebral palsy or brain injury a randomized controlled trial
BMC Pediatrics, 2018Co-Authors: Michelle Jackman, Iona Novak, Natasha A. Lannin, Elspeth Froude, Laura Miller, Claire GaleaAbstract:Functional hand splinting is a common therapeutic intervention for children with neurological conditions. The aim of this study was to investigate the effectiveness of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach over and above conventional functional hand splinting, and in combination with splinting, for children with cerebral palsy or brain injury. A multisite, assessor-blinded, parallel, randomized controlled trial was conducted in Australia. Participants (n = 45) were randomly allocated to one of three groups; (1) splint only (n = 15); (2) CO-OP only (n = 15); (3) CO-OP + splint (n = 15). Inclusion: age 4–15 years; diagnosis of cerebral palsy or brain injury; Manual Ability Classification System I–IV; hand function goals; sufficient language, Cognitive and behavioral ability. Primary outcome measures were the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS). Treatment duration for all groups was 2 weeks. CO-OP was provided in a group format, 1 h per day for 10 consecutive weekdays, with parents actively involved in the group. Hand splints were wrist cock-up splints that were worn during task practice. Three individual goals were set and all participants were encouraged to complete a daily home program of practicing goals for 1 h. Analyses were conducted on an intention to treat basis. The COPM showed that all three groups improved from baseline to immediately post-treatment. GAS showed a statistically significant difference immediately post-intervention between the splint only and CO-OP only groups p = 0.034), and the splint only and CO-OP + splint group (p = 0.047) favoring CO-OP after controlling for baseline. The CO-OP Approach™ appeared to enhance goal achievement over and above a functional hand splint alone. There was no added benefit of using hand splints in conjunction with CO-OP, compared to CO-OP alone. Hand splints were not well tolerated in this population. Practice of functional goals, through CO-OP or practice at home, leads to goal achievement for children with cerebral palsy or brain injury. Registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12613000690752 ) on 24/06/2013.
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the Cognitive Orientation to daily occupational performance co op approach best responders in children with cerebral palsy and brain injury
Research in Developmental Disabilities, 2018Co-Authors: Michelle Jackman, Iona Novak, Natasha A. Lannin, Claire Galea, Elspeth FroudeAbstract:Abstract Background Identifying the characteristics of individuals who are most likely to respond to a certain rehabilitation intervention is advantageous for the child, family, clinicians and the healthcare system. Aim To investigate the individual characteristics of children with cerebral palsy or brain injury who responded best to the Cognitive Orientation to daily Occupational Performance (CO-OP) Approach. Methods Post hoc analyses were conducted on 30 participants who participated in CO-OP within a larger randomized controlled trial. Inclusion: cerebral palsy or brain injury; age 4–15 years; Manual Abilities Classification System (MACS) I-IV; goals related to hand function; sufficient Cognitive, language and behavioral ability to undertake CO-OP. Outcome measures were the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS) collected immediately following the two week intervention period. Results Following CO-OP, 67% (n = 20) of participants showed a statistically significant response on the COPM, and 73%(n = 22) on the GAS. Nine participants were classified as best responders. When compared to non-responders, best responders were more likely to be female (p = .025) and to have received a higher dose of CO-OP (p = .028). Neither age nor MACS were predictors of response. Conclusion To be successful in CO-OP, children should meet the prerequisites of CO-OP, particularly the language and Cognitive ability to set goals and communicate effectively with the therapist. In this small sample, children with comorbidities were less likely to achieve goals, females were more likely to respond and dose of therapy was important to success.
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parents experience of undertaking an intensive Cognitive Orientation to daily occupational performance co op group for children with cerebral palsy
Disability and Rehabilitation, 2017Co-Authors: Michelle Jackman, Iona Novak, Natasha A. Lannin, Elspeth FroudeAbstract:AbstractPurpose: The purpose of this study was to explore the experience of parents of children with cerebral palsy (CP) who participated in an intensive Cognitive Orientation to daily occupational performance (CO-OP) group program addressing child chosen goals.Method: Participants were six parents of children with CP who participated in a CO-OP upper limb task-specific training program. Parents participated in semi-structured interviews conducted via phone. A grounded theory approach was used. Interviews were transcribed verbatim and coded to identify categories and overarching themes of the parent experience of CO-OP.Results: The theory of CO-OP for children with CP was one of offering a unique and motivating learning experience for both the child and the parent, differing from other therapeutic approaches that families had previously been involved in. Five categories were identified: the unique benefits of CO-OP; the importance of intensity; the child’s motivation; challenging the parent role; and the ...
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Effectiveness of functional hand splinting and the Cognitive Orientation to occupational performance (CO-OP) approach in children with cerebral palsy and brain injury: two randomised controlled trial protocols.
BMC Neurology, 2014Co-Authors: Michelle Jackman, Iona Novak, Natasha A. LanninAbstract:Cerebral palsy (CP) and brain injury (BI) are common conditions that have devastating effects on a child’s ability to use their hands. Hand splinting and task-specific training are two interventions that are often used to address deficits in upper limb skills, both in isolation or concurrently. The aim of this paper is to describe the method to be used to conduct two randomised controlled trials (RCT) investigating (a) the immediate effect of functional hand splints, and (b) the effect of functional hand splints used concurrently with task-specific training compared to functional hand splints alone, and to task-specific training alone in children with CP and BI. The Cognitive Orientation to Occupational Performance (CO-OP) approach will be the task-specific training approach used. Two concurrent trials; a two group, parallel design, RCT with a sample size of 30 participants (15 per group); and a three group, parallel design, assessor blinded, RCT with a sample size of 45 participants (15 per group). Inclusion criteria: age 4-15 years; diagnosis of CP or BI; Manual Abilities Classification System (MACS) level I – IV; hand function goals; impaired hand function; the Cognitive, language and behavioural ability to participate in CO-OP. Participants will be randomly allocated to one of 3 groups; (1) functional hand splint only (n=15); (2) functional hand splint combined with task-specific training (n=15); (3) task-specific training only (n=15). Allocation concealment will be achieved using sequentially numbered, sealed opaque envelopes opened by an off-site officer after baseline measures. Treatment will be provided for a period of 2 weeks, with outcome measures taken at baseline, 1 hour after randomisation, 2 weeks and 10 weeks. The functional hand splint will be a wrist cock-up splint (+/- thumb support or supination strap). Task-specific training will involve 10 sessions of CO-OP provided in a group of 2-4 children. Primary outcome measures will be the Canadian Occupational Performance Measure (COPM) and the Goal Attainment Scale (GAS). Analysis will be conducted on an intention-to-treat basis. This paper outlines the protocol for two randomised controlled trials investigating functional hand splints and CO-OP for children with CP and BI.
Helene J. Polatajko - One of the best experts on this subject based on the ideXlab platform.
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therapists experience of the Cognitive Orientation to daily occupational performance co op approach shifting from conventional practice
Scandinavian Journal of Occupational Therapy, 2020Co-Authors: Adora Chui, Helene J. Polatajko, Debra Cameron, Daniela Mazzitti, Emily Nalder, Deirdre R DawsonAbstract:Background: The CO-OP ApproachTM has been increasingly used in research and practice, yet its critical elements and implementation challenges are largely undescribed. Obtaining therapists’ perspect...
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the Cognitive Orientation to daily occupational performance approach and transfer a scoping review
Otjr-occupation Participation and Health, 2018Co-Authors: Adina Houldin, Sara Mcewen, Mackenzie W Howell, Helene J. PolatajkoAbstract:Transferring learning from therapy to everyday life skills is a necessary step for successful therapy outcomes, yet rarely addressed and achieved. However, a Cognitive approach to skill acquisition...
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Cognitive Orientation to daily occupational performance co op a new approach for children with cerebral palsy
Physical & Occupational Therapy in Pediatrics, 2017Co-Authors: Debra Cameron, Cheryl Missiuna, Tammy Craig, Brydne Edwards, Heidi Schwellnus, Helene J. PolatajkoAbstract:ABSTRACTAims: The results of a small single-case study series suggested that Cognitive Orientation to daily Occupational Performance (CO-OP) may be a successful approach for children with cerebral palsy (CP). Therefore a pilot randomized controlled trial was conducted with the following research questions—is CO-OP a feasible approach to use with children with CP, what are the effects of CO-OP when compared to usual practice, and is a larger study warranted? Methods: 18 children between age 7 and 12 (nine in CO-OP group and nine in Current Usual Practice Approach (CUPA) group) received ten 1-hour sessions of intervention on average once per week at home. Primary outcome measures were the Canadian Occupational Performance Measure and the Performance Quality Rating Scale (PQRS). PQRS assessors were blind to group allocation and timing of assessment. Results: All children in the CO-OP group were able to learn the strategies and achieve their chosen goals, thus demonstrating the feasibility of the approach. Bo...
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the Cognitive Orientation to daily occupational performance co op a scoping review
Canadian Journal of Occupational Therapy, 2016Co-Authors: Emma M Scammell, Stephanie Bates V Bates, Adina Houldin, Helene J. PolatajkoAbstract:Background.The Cognitive Orientation to daily Occupational Performance (CO-OP) approach—now trademarked as the CO-OPApproach—was introduced in the literature in 2001 as an intervention to improve r...
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Combined Cognitive-Strategy and Task-Specific Training Affects Cognition and Upper-Extremity Function in Subacute Stroke: An Exploratory Randomized Controlled Trial
American Journal of Occupational Therapy, 2016Co-Authors: Timothy J. Wolf, Meghan Doherty, Jorge Rios, Helene J. Polatajko, Carolyn M. Baum, Dianne Cirone, Sara McewenAbstract:: The purpose of this study was to estimate the effect of Cognitive Orientation to Daily Occupational Performance (CO-OP) compared with usual occupational therapy on upper-extremity movement, Cognitive flexibility, and stroke impact in people less than 3 mo after stroke. An exploratory, single-blind randomized controlled trial was conducted with people referred to outpatient occupational therapy services at two rehabilitation centers. Arm movement was measured with the Action Research Arm Test, Cognitive flexibility with the Delis-Kaplan Executive Function System Trail Making subtest, and stroke impact with subscales of the Stroke Impact Scale. A total of 35 participants were randomized, and 26 completed the intervention. CO-OP demonstrated measurable effects over usual care on all measures. These data provide early support for the use of CO-OP to improve performance and remediate Cognitive and arm movement impairments after stroke over usual care; however, future study is warranted to confirm the effects observed in this trial.
Elspeth Froude - One of the best experts on this subject based on the ideXlab platform.
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effectiveness of Cognitive Orientation to daily occupational performance over and above functional hand splints for children with cerebral palsy or brain injury a randomized controlled trial
BMC Pediatrics, 2018Co-Authors: Michelle Jackman, Iona Novak, Natasha A. Lannin, Elspeth Froude, Laura Miller, Claire GaleaAbstract:Functional hand splinting is a common therapeutic intervention for children with neurological conditions. The aim of this study was to investigate the effectiveness of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach over and above conventional functional hand splinting, and in combination with splinting, for children with cerebral palsy or brain injury. A multisite, assessor-blinded, parallel, randomized controlled trial was conducted in Australia. Participants (n = 45) were randomly allocated to one of three groups; (1) splint only (n = 15); (2) CO-OP only (n = 15); (3) CO-OP + splint (n = 15). Inclusion: age 4–15 years; diagnosis of cerebral palsy or brain injury; Manual Ability Classification System I–IV; hand function goals; sufficient language, Cognitive and behavioral ability. Primary outcome measures were the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS). Treatment duration for all groups was 2 weeks. CO-OP was provided in a group format, 1 h per day for 10 consecutive weekdays, with parents actively involved in the group. Hand splints were wrist cock-up splints that were worn during task practice. Three individual goals were set and all participants were encouraged to complete a daily home program of practicing goals for 1 h. Analyses were conducted on an intention to treat basis. The COPM showed that all three groups improved from baseline to immediately post-treatment. GAS showed a statistically significant difference immediately post-intervention between the splint only and CO-OP only groups p = 0.034), and the splint only and CO-OP + splint group (p = 0.047) favoring CO-OP after controlling for baseline. The CO-OP Approach™ appeared to enhance goal achievement over and above a functional hand splint alone. There was no added benefit of using hand splints in conjunction with CO-OP, compared to CO-OP alone. Hand splints were not well tolerated in this population. Practice of functional goals, through CO-OP or practice at home, leads to goal achievement for children with cerebral palsy or brain injury. Registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12613000690752 ) on 24/06/2013.
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the Cognitive Orientation to daily occupational performance co op approach best responders in children with cerebral palsy and brain injury
Research in Developmental Disabilities, 2018Co-Authors: Michelle Jackman, Iona Novak, Natasha A. Lannin, Claire Galea, Elspeth FroudeAbstract:Abstract Background Identifying the characteristics of individuals who are most likely to respond to a certain rehabilitation intervention is advantageous for the child, family, clinicians and the healthcare system. Aim To investigate the individual characteristics of children with cerebral palsy or brain injury who responded best to the Cognitive Orientation to daily Occupational Performance (CO-OP) Approach. Methods Post hoc analyses were conducted on 30 participants who participated in CO-OP within a larger randomized controlled trial. Inclusion: cerebral palsy or brain injury; age 4–15 years; Manual Abilities Classification System (MACS) I-IV; goals related to hand function; sufficient Cognitive, language and behavioral ability to undertake CO-OP. Outcome measures were the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS) collected immediately following the two week intervention period. Results Following CO-OP, 67% (n = 20) of participants showed a statistically significant response on the COPM, and 73%(n = 22) on the GAS. Nine participants were classified as best responders. When compared to non-responders, best responders were more likely to be female (p = .025) and to have received a higher dose of CO-OP (p = .028). Neither age nor MACS were predictors of response. Conclusion To be successful in CO-OP, children should meet the prerequisites of CO-OP, particularly the language and Cognitive ability to set goals and communicate effectively with the therapist. In this small sample, children with comorbidities were less likely to achieve goals, females were more likely to respond and dose of therapy was important to success.
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parents experience of undertaking an intensive Cognitive Orientation to daily occupational performance co op group for children with cerebral palsy
Disability and Rehabilitation, 2017Co-Authors: Michelle Jackman, Iona Novak, Natasha A. Lannin, Elspeth FroudeAbstract:AbstractPurpose: The purpose of this study was to explore the experience of parents of children with cerebral palsy (CP) who participated in an intensive Cognitive Orientation to daily occupational performance (CO-OP) group program addressing child chosen goals.Method: Participants were six parents of children with CP who participated in a CO-OP upper limb task-specific training program. Parents participated in semi-structured interviews conducted via phone. A grounded theory approach was used. Interviews were transcribed verbatim and coded to identify categories and overarching themes of the parent experience of CO-OP.Results: The theory of CO-OP for children with CP was one of offering a unique and motivating learning experience for both the child and the parent, differing from other therapeutic approaches that families had previously been involved in. Five categories were identified: the unique benefits of CO-OP; the importance of intensity; the child’s motivation; challenging the parent role; and the ...
Claire Galea - One of the best experts on this subject based on the ideXlab platform.
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effectiveness of Cognitive Orientation to daily occupational performance over and above functional hand splints for children with cerebral palsy or brain injury a randomized controlled trial
BMC Pediatrics, 2018Co-Authors: Michelle Jackman, Iona Novak, Natasha A. Lannin, Elspeth Froude, Laura Miller, Claire GaleaAbstract:Functional hand splinting is a common therapeutic intervention for children with neurological conditions. The aim of this study was to investigate the effectiveness of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach over and above conventional functional hand splinting, and in combination with splinting, for children with cerebral palsy or brain injury. A multisite, assessor-blinded, parallel, randomized controlled trial was conducted in Australia. Participants (n = 45) were randomly allocated to one of three groups; (1) splint only (n = 15); (2) CO-OP only (n = 15); (3) CO-OP + splint (n = 15). Inclusion: age 4–15 years; diagnosis of cerebral palsy or brain injury; Manual Ability Classification System I–IV; hand function goals; sufficient language, Cognitive and behavioral ability. Primary outcome measures were the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS). Treatment duration for all groups was 2 weeks. CO-OP was provided in a group format, 1 h per day for 10 consecutive weekdays, with parents actively involved in the group. Hand splints were wrist cock-up splints that were worn during task practice. Three individual goals were set and all participants were encouraged to complete a daily home program of practicing goals for 1 h. Analyses were conducted on an intention to treat basis. The COPM showed that all three groups improved from baseline to immediately post-treatment. GAS showed a statistically significant difference immediately post-intervention between the splint only and CO-OP only groups p = 0.034), and the splint only and CO-OP + splint group (p = 0.047) favoring CO-OP after controlling for baseline. The CO-OP Approach™ appeared to enhance goal achievement over and above a functional hand splint alone. There was no added benefit of using hand splints in conjunction with CO-OP, compared to CO-OP alone. Hand splints were not well tolerated in this population. Practice of functional goals, through CO-OP or practice at home, leads to goal achievement for children with cerebral palsy or brain injury. Registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12613000690752 ) on 24/06/2013.
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the Cognitive Orientation to daily occupational performance co op approach best responders in children with cerebral palsy and brain injury
Research in Developmental Disabilities, 2018Co-Authors: Michelle Jackman, Iona Novak, Natasha A. Lannin, Claire Galea, Elspeth FroudeAbstract:Abstract Background Identifying the characteristics of individuals who are most likely to respond to a certain rehabilitation intervention is advantageous for the child, family, clinicians and the healthcare system. Aim To investigate the individual characteristics of children with cerebral palsy or brain injury who responded best to the Cognitive Orientation to daily Occupational Performance (CO-OP) Approach. Methods Post hoc analyses were conducted on 30 participants who participated in CO-OP within a larger randomized controlled trial. Inclusion: cerebral palsy or brain injury; age 4–15 years; Manual Abilities Classification System (MACS) I-IV; goals related to hand function; sufficient Cognitive, language and behavioral ability to undertake CO-OP. Outcome measures were the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS) collected immediately following the two week intervention period. Results Following CO-OP, 67% (n = 20) of participants showed a statistically significant response on the COPM, and 73%(n = 22) on the GAS. Nine participants were classified as best responders. When compared to non-responders, best responders were more likely to be female (p = .025) and to have received a higher dose of CO-OP (p = .028). Neither age nor MACS were predictors of response. Conclusion To be successful in CO-OP, children should meet the prerequisites of CO-OP, particularly the language and Cognitive ability to set goals and communicate effectively with the therapist. In this small sample, children with comorbidities were less likely to achieve goals, females were more likely to respond and dose of therapy was important to success.
Natasha A. Lannin - One of the best experts on this subject based on the ideXlab platform.
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effectiveness of Cognitive Orientation to daily occupational performance over and above functional hand splints for children with cerebral palsy or brain injury a randomized controlled trial
BMC Pediatrics, 2018Co-Authors: Michelle Jackman, Iona Novak, Natasha A. Lannin, Elspeth Froude, Laura Miller, Claire GaleaAbstract:Functional hand splinting is a common therapeutic intervention for children with neurological conditions. The aim of this study was to investigate the effectiveness of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach over and above conventional functional hand splinting, and in combination with splinting, for children with cerebral palsy or brain injury. A multisite, assessor-blinded, parallel, randomized controlled trial was conducted in Australia. Participants (n = 45) were randomly allocated to one of three groups; (1) splint only (n = 15); (2) CO-OP only (n = 15); (3) CO-OP + splint (n = 15). Inclusion: age 4–15 years; diagnosis of cerebral palsy or brain injury; Manual Ability Classification System I–IV; hand function goals; sufficient language, Cognitive and behavioral ability. Primary outcome measures were the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS). Treatment duration for all groups was 2 weeks. CO-OP was provided in a group format, 1 h per day for 10 consecutive weekdays, with parents actively involved in the group. Hand splints were wrist cock-up splints that were worn during task practice. Three individual goals were set and all participants were encouraged to complete a daily home program of practicing goals for 1 h. Analyses were conducted on an intention to treat basis. The COPM showed that all three groups improved from baseline to immediately post-treatment. GAS showed a statistically significant difference immediately post-intervention between the splint only and CO-OP only groups p = 0.034), and the splint only and CO-OP + splint group (p = 0.047) favoring CO-OP after controlling for baseline. The CO-OP Approach™ appeared to enhance goal achievement over and above a functional hand splint alone. There was no added benefit of using hand splints in conjunction with CO-OP, compared to CO-OP alone. Hand splints were not well tolerated in this population. Practice of functional goals, through CO-OP or practice at home, leads to goal achievement for children with cerebral palsy or brain injury. Registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12613000690752 ) on 24/06/2013.
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the Cognitive Orientation to daily occupational performance co op approach best responders in children with cerebral palsy and brain injury
Research in Developmental Disabilities, 2018Co-Authors: Michelle Jackman, Iona Novak, Natasha A. Lannin, Claire Galea, Elspeth FroudeAbstract:Abstract Background Identifying the characteristics of individuals who are most likely to respond to a certain rehabilitation intervention is advantageous for the child, family, clinicians and the healthcare system. Aim To investigate the individual characteristics of children with cerebral palsy or brain injury who responded best to the Cognitive Orientation to daily Occupational Performance (CO-OP) Approach. Methods Post hoc analyses were conducted on 30 participants who participated in CO-OP within a larger randomized controlled trial. Inclusion: cerebral palsy or brain injury; age 4–15 years; Manual Abilities Classification System (MACS) I-IV; goals related to hand function; sufficient Cognitive, language and behavioral ability to undertake CO-OP. Outcome measures were the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS) collected immediately following the two week intervention period. Results Following CO-OP, 67% (n = 20) of participants showed a statistically significant response on the COPM, and 73%(n = 22) on the GAS. Nine participants were classified as best responders. When compared to non-responders, best responders were more likely to be female (p = .025) and to have received a higher dose of CO-OP (p = .028). Neither age nor MACS were predictors of response. Conclusion To be successful in CO-OP, children should meet the prerequisites of CO-OP, particularly the language and Cognitive ability to set goals and communicate effectively with the therapist. In this small sample, children with comorbidities were less likely to achieve goals, females were more likely to respond and dose of therapy was important to success.
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parents experience of undertaking an intensive Cognitive Orientation to daily occupational performance co op group for children with cerebral palsy
Disability and Rehabilitation, 2017Co-Authors: Michelle Jackman, Iona Novak, Natasha A. Lannin, Elspeth FroudeAbstract:AbstractPurpose: The purpose of this study was to explore the experience of parents of children with cerebral palsy (CP) who participated in an intensive Cognitive Orientation to daily occupational performance (CO-OP) group program addressing child chosen goals.Method: Participants were six parents of children with CP who participated in a CO-OP upper limb task-specific training program. Parents participated in semi-structured interviews conducted via phone. A grounded theory approach was used. Interviews were transcribed verbatim and coded to identify categories and overarching themes of the parent experience of CO-OP.Results: The theory of CO-OP for children with CP was one of offering a unique and motivating learning experience for both the child and the parent, differing from other therapeutic approaches that families had previously been involved in. Five categories were identified: the unique benefits of CO-OP; the importance of intensity; the child’s motivation; challenging the parent role; and the ...
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Effectiveness of functional hand splinting and the Cognitive Orientation to occupational performance (CO-OP) approach in children with cerebral palsy and brain injury: two randomised controlled trial protocols.
BMC Neurology, 2014Co-Authors: Michelle Jackman, Iona Novak, Natasha A. LanninAbstract:Cerebral palsy (CP) and brain injury (BI) are common conditions that have devastating effects on a child’s ability to use their hands. Hand splinting and task-specific training are two interventions that are often used to address deficits in upper limb skills, both in isolation or concurrently. The aim of this paper is to describe the method to be used to conduct two randomised controlled trials (RCT) investigating (a) the immediate effect of functional hand splints, and (b) the effect of functional hand splints used concurrently with task-specific training compared to functional hand splints alone, and to task-specific training alone in children with CP and BI. The Cognitive Orientation to Occupational Performance (CO-OP) approach will be the task-specific training approach used. Two concurrent trials; a two group, parallel design, RCT with a sample size of 30 participants (15 per group); and a three group, parallel design, assessor blinded, RCT with a sample size of 45 participants (15 per group). Inclusion criteria: age 4-15 years; diagnosis of CP or BI; Manual Abilities Classification System (MACS) level I – IV; hand function goals; impaired hand function; the Cognitive, language and behavioural ability to participate in CO-OP. Participants will be randomly allocated to one of 3 groups; (1) functional hand splint only (n=15); (2) functional hand splint combined with task-specific training (n=15); (3) task-specific training only (n=15). Allocation concealment will be achieved using sequentially numbered, sealed opaque envelopes opened by an off-site officer after baseline measures. Treatment will be provided for a period of 2 weeks, with outcome measures taken at baseline, 1 hour after randomisation, 2 weeks and 10 weeks. The functional hand splint will be a wrist cock-up splint (+/- thumb support or supination strap). Task-specific training will involve 10 sessions of CO-OP provided in a group of 2-4 children. Primary outcome measures will be the Canadian Occupational Performance Measure (COPM) and the Goal Attainment Scale (GAS). Analysis will be conducted on an intention-to-treat basis. This paper outlines the protocol for two randomised controlled trials investigating functional hand splints and CO-OP for children with CP and BI.